| NPI | 1629714399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2303135) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 2303135) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-10-05 |